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Le Provost B, Parent MÉ, Villeneuve PJ, Waddingham CM, Brook JR, Lavigne E, Dugandzic R, Harris SA. Residential exposure to ambient fine particulate matter (PM 2.5) and nitrogen dioxide (NO 2) and incident breast cancer among young women in Ontario, Canada. Cancer Epidemiol 2024; 92:102606. [PMID: 38986354 DOI: 10.1016/j.canep.2024.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/10/2024] [Accepted: 06/23/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Air pollution has been classified as a human carcinogen based largely on findings for respiratory cancers. Emerging, but limited, evidence suggests that it increases the risk of breast cancer, particularly among younger women. We characterized associations between residential exposure to ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) and breast cancer. Analyses were performed using data collected in the Ontario Environmental Health Study (OEHS). METHODS The OEHS, a population-based case-control study, identified incident cases of breast cancer in Ontario, Canada among women aged 18-45 between 2013 and 2015. A total of 465 pathologically confirmed primary breast cancer cases were identified from the Ontario Cancer Registry, while 242 population-based controls were recruited using random-digit dialing. Self-reported questionnaires were used to collect risk factor data and residential histories. Land-use regression and remote-sensing estimates of NO2 and PM2.5, respectively, were assigned to the residential addresses at interview, five years earlier, and at menarche. Logistic regression was used to estimate odds ratios (OR) and their 95 % confidence intervals (CI) in relation to an interquartile range (IQR) increase in air pollution, adjusting for possible confounders. RESULTS PM2.5 and NO2 were positively correlated with each other (r = 0.57). An IQR increase of PM2.5 (1.9 µg/m3) and NO2 (6.6 ppb) at interview residence were associated with higher odds of breast cancer and the adjusted ORs and 95 % CIs were 1.37 (95 % CI = 0.98-1.91) and 2.33 (95 % CI = 1.53-3.53), respectively. An increased odds of breast cancer was observed with an IQR increase in NO2 at residence five years earlier (OR = 2.16, 95 % CI: 1.41-3.31), while no association was observed with PM2.5 (OR = 0.96, 95 % CI 0.64-1.42). CONCLUSIONS Our findings support the hypothesis that exposure to ambient air pollution, especially those from traffic sources (i.e., NO2), increases the risk of breast cancer in young women.
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Affiliation(s)
- Blandine Le Provost
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), École de Santé Publique, Université de Bordeaux, Bordeaux, France
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, Laval, Québec, Canada; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada; Centre de recherche du CHUM, Montréal, Québec, Canada
| | - Paul J Villeneuve
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada.
| | | | - Jeffrey R Brook
- Divisions of Epidemiology and Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Civil and Mineral Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Ottawa, Ontario, Canada
| | - Rose Dugandzic
- Office of Environmental Health, Health Canada, Ottawa, Ontario, Canada
| | - Shelley A Harris
- Divisions of Epidemiology and Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Tomlinson MM, Pugh F, Nail AN, Newton JD, Udoh K, Abraham S, Kavalukas S, Guinn B, Tamimi RM, Laden F, Iyer HS, States JC, Ruther M, Ellis CT, DuPré NC. Heavy-metal associated breast cancer and colorectal cancer hot spots and their demographic and socioeconomic characteristics. Cancer Causes Control 2024:10.1007/s10552-024-01894-0. [PMID: 38916703 DOI: 10.1007/s10552-024-01894-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/01/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Cancer registries offer an avenue to identify cancer clusters across large populations and efficiently examine potential environmental harms affecting cancer. The role of known metal carcinogens (i.e., cadmium, arsenic, nickel, chromium(VI)) in breast and colorectal carcinogenesis is largely unknown. Historically marginalized communities are disproportionately exposed to metals, which could explain cancer disparities. We examined area-based metal exposures and odds of residing in breast and colorectal cancer hotspots utilizing state tumor registry data and described the characteristics of those living in heavy metal-associated cancer hotspots. METHODS Breast and colorectal cancer hotspots were mapped across Kentucky, and area-based ambient metal exposure to cadmium, arsenic, nickel, and chromium(VI) were extracted from the 2014 National Air Toxics Assessment for Kentucky census tracts. Among colorectal cancer (n = 56,598) and female breast cancer (n = 77,637) diagnoses in Kentucky, we used logistic regression models to estimate Odds Ratios (ORs) and 95% Confidence Intervals to examine the association between ambient metal concentrations and odds of residing in cancer hotspots, independent of individual-level and neighborhood risk factors. RESULTS Higher ambient metal exposures were associated with higher odds of residing in breast and colorectal cancer hotspots. Populations in breast and colorectal cancer hotspots were disproportionately Black and had markers of lower socioeconomic status. Furthermore, adjusting for age, race, tobacco and neighborhood factors did not significantly change cancer hotspot ORs for ambient metal exposures analyzed. CONCLUSION Ambient metal exposures contribute to higher cancer rates in certain geographic areas that are largely composed of marginalized populations. Individual-level assessments of metal exposures and cancer disparities are needed.
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Affiliation(s)
- Madeline M Tomlinson
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Felicia Pugh
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
- Louisville Metro Department of Public Health and Wellness, Center for Health Equity, Louisville, KY, USA
| | - Alexandra N Nail
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Johnnie D Newton
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Karen Udoh
- Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Stephie Abraham
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Sandy Kavalukas
- Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Brian Guinn
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medical, New York, NY, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology and Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Hari S Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - J Christopher States
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, KY, USA
- Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA
| | - Matthew Ruther
- Department of Urban and Public Affairs, College of Arts and Sciences, University of Louisville, Louisville, KY, USA
| | - C Tyler Ellis
- Department of Surgery, School of Medicine, University of Louisville, Louisville, KY, USA
- Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA
| | - Natalie C DuPré
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E Gray St, Louisville, KY, 40202, USA.
- Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY, USA.
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Carvalho PT, Niza-Ribeiro J, Amorim I, Queiroga F, Severo M, Ribeiro AI, Pinello K. Comparative epidemiological study of breast cancer in humans and canine mammary tumors: insights from Portugal. Front Vet Sci 2023; 10:1271097. [PMID: 38098996 PMCID: PMC10720630 DOI: 10.3389/fvets.2023.1271097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Dogs spontaneously develop mammary gland tumors (MGT) and exhibit striking similarities in clinical and epidemiological characteristics to human breast cancer (HBC). Descriptive and comparative analysis of HBC and canine MGT with a focus on evaluating similarities and geographical distribution were the aims of this study. HBC cases were obtained from North Regional Oncological Registry (RORENO) (2010-2015) and canine MGT cases from Vet-OncoNet (2019-2022). Analyses were performed based on published and well accepted classification systems (ICD-O-3.2 for humans and Vet-ICD-O-canine-1). Age-standardized incidence risks (ASIR) of Porto district municipalities were calculated using 2021 Portuguese census (INE) and data from the Portuguese animal registration system (SIAC). Among 7,674 HBC cases and 1,140 MGT cases, a similar age and sex distribution pattern was observed. Approximately 69.2% of HBC cases were between 40 and 69 years old, while 66.9% of MGT cases were diagnosed between 7 and 12 years old (mean age of 9.6 years, SD = 2.6). In women, Invasive breast carcinoma (8500/3) was the most common histological type (n = 5,679, 74%) while in dogs it was the Complex Carcinoma (8983.1/3) (n = 205, 39%). Cocker and Yorkshire Terriers exhibited the highest relative risks (3.2 and 1.6, p < 0.05, respectively) when compared to cross breed dogs. The municipalities' ASIR of the two species exhibited a high correlation (R = 0.85, p < 0.01) and the spatial cluster analysis revealed similar geographic hotspots. Also, higher ASIR values both in women and dogs were more frequently found in urbanized areas compared to rural areas. This research sheds light on the shared features and geographical correlation between HBC and canine MGT, highlighting the potential of cross-species environmental oncology studies.
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Affiliation(s)
- Paulo Tiago Carvalho
- Vet-OncoNet, Population Studies Department, School of Medicine and Biomedical Sciences, ICBAS, University of Porto, Porto, Portugal
| | - João Niza-Ribeiro
- Vet-OncoNet, Population Studies Department, School of Medicine and Biomedical Sciences, ICBAS, University of Porto, Porto, Portugal
- Epidemiology Unit (EPIUnit), Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Irina Amorim
- Department of Pathology and Molecular Immunology, School of Medicine and Biomedical Sciences ICBAS, University of Porto, Porto, Portugal
| | - Felisbina Queiroga
- Department of Veterinary Sciences, University Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- Centre for Animal and Veterinary Science (CECAV), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
- Center for Animal Science Studies, Institute of Sciences, Technologies and Agroenvironment (CECA-ICETA), University of Porto, Porto, Portugal
| | - Milton Severo
- Epidemiology Unit (EPIUnit), Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Ana Isabel Ribeiro
- Epidemiology Unit (EPIUnit), Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Katia Pinello
- Vet-OncoNet, Population Studies Department, School of Medicine and Biomedical Sciences, ICBAS, University of Porto, Porto, Portugal
- Epidemiology Unit (EPIUnit), Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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Zhang P, Zhou C, Zhao K, Liu C, Liu C, He F, Peng W, Jia X, Mi J. Associations of air pollution and greenness with global burden of breast cancer: an ecological study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:103921-103931. [PMID: 37697184 DOI: 10.1007/s11356-023-29579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
Despite the significance of the associations of air pollution and greenness with the risk of breast cancer, this topic has not been investigated on a global scale. We conducted an ecological study using 7 years of data from 162 countries. Disability-adjusted life years (DALYs) and incidence data were used to represent the breast cancer disease burden. Particulate matter with a diameter < 2.5 μm (PM2.5), ozone (O3), nitrogen dioxide (NO2), and the normalized difference vegetation index (NDVI) were adopted as our exposures. We employed generalized linear mixed models to explore the relationship between air pollution and greenness on breast cancer disease burden. The rate ratio (RR) and its 95% confidence interval (CI) indicate the effect size. There is a positive association between air pollution and the burden of breast cancer disease. Contrarily, per interquartile range increment in NDVI was negatively associated with DALYs and incidence. In terms of air pollutants and breast cancer, NDVI seems to have a significant influence on the relationship between these two conditions. A higher amount of greenness helps to alleviate the negative association of air pollution on breast cancer. PM2.5 and O3 play a mediating role in the relationship between greenness and breast cancer disease burden. In areas with higher levels of greenness, there is a possibility that the inverse association between air pollutants and the burden of breast cancer may be influenced.
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Affiliation(s)
- Peiyao Zhang
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Cheng Zhou
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Chengrong Liu
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Chao Liu
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Fenfen He
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Wenjia Peng
- School of Public Health, Fudan University, Shanghai, China
| | - Xianjie Jia
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China
| | - Jing Mi
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, No. 2600 Donghai Avenue, Bengbu, 233000, China.
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Wei Y, Danesh Yazdi M, Ma T, Castro E, Liu CS, Qiu X, Healy J, Vu BN, Wang C, Shi L, Schwartz J. Additive effects of 10-year exposures to PM 2.5 and NO 2 and primary cancer incidence in American older adults. Environ Epidemiol 2023; 7:e265. [PMID: 37545804 PMCID: PMC10402937 DOI: 10.1097/ee9.0000000000000265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
Epidemiologic evidence on the relationships between air pollution and the risks of primary cancers other than lung cancer remained largely lacking. We aimed to examine associations of 10-year exposures to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) with risks of breast, prostate, colorectal, and endometrial cancers. Methods For each cancer, we constructed a separate cohort among the national Medicare beneficiaries during 2000 to 2016. We simultaneously examined the additive associations of six exposures, namely, moving average exposures to PM2.5 and NO2 over the year of diagnosis and previous 2 years, previous 3 to 5 years, and previous 6 to 10 years, with the risk of first cancer diagnosis after 10 years of follow-up, during which there was no cancer diagnosis. Results The cohorts included 2.2 to 6.5 million subjects for different cancers. Exposures to PM2.5 and NO2 were associated with increased risks of colorectal and prostate cancers but were not associated with endometrial cancer risk. NO2 was associated with a decreased risk of breast cancer, while the association for PM2.5 remained inconclusive. At exposure levels below the newly updated World Health Organization Air Quality Guideline, we observed substantially larger associations between most exposures and the risks of all cancers, which were translated to hundreds to thousands new cancer cases per year within the cohort per unit increase in each exposure. Conclusions These findings suggested substantial cancer burden was associated with exposures to PM2.5 and NO2, emphasizing the urgent need for strategies to mitigate air pollution levels.
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Affiliation(s)
- Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Mahdieh Danesh Yazdi
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Tszshan Ma
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cristina Su Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - James Healy
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Bryan N. Vu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cuicui Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Hüls A. Improvement of air quality has a positive impact on lung growth, particularly during puberty. Eur Respir J 2023; 61:61/5/2300345. [PMID: 37147009 DOI: 10.1183/13993003.00345-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 05/07/2023]
Affiliation(s)
- Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Liu H, Zhang X, Sun Z, Chen Y. Ambient Fine Particulate Matter and Cancer: Current Evidence and Future Perspectives. Chem Res Toxicol 2023; 36:141-156. [PMID: 36688945 DOI: 10.1021/acs.chemrestox.2c00216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The high incidence of cancer has placed an enormous health and economic burden on countries around the world. In addition to evidence of epidemiological studies, conclusive evidence from animal experiments and mechanistic studies have also shown that morbidity and mortality of some cancers can be attributed to ambient fine particulate matter (PM2.5) exposure, especially in lung cancer. However, the underlying carcinogenetic mechanisms of PM2.5 remain unclear. Furthermore, in terms of risks of other types of cancer, both epidemiological and mechanistic evidence are more limited and scattered, and the results are also inconsistent. In order to sort out the carcinogenic effect of PM2.5, this paper reviews the association of cancers with PM2.5 based on epidemiological and biological evidence including genetic, epigenetic, and molecular mechanisms. The limitations of existing researches and the prospects for the future are also well clarified in this paper to provide insights for future studies.
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Affiliation(s)
- Hanrui Liu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Xiaoke Zhang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Yueyue Chen
- Department of Toxicology and Sanitary Chemistry, School of Public Health, and Beijing Key Laboratory of Environment Toxicology, Capital Medical University, Beijing 100069, PR China
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Niehoff NM, Terry MB, Bookwalter DB, Kaufman JD, O'Brien KM, Sandler DP, White AJ. Air Pollution and Breast Cancer: An Examination of Modification By Underlying Familial Breast Cancer Risk. Cancer Epidemiol Biomarkers Prev 2022; 31:422-429. [PMID: 34906967 PMCID: PMC8825697 DOI: 10.1158/1055-9965.epi-21-1140] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/18/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND An increased familial risk of breast cancer may be due to both shared genetics and environment. Women with a breast cancer family history may have a higher prevalence of breast cancer-related gene variants and thus increased susceptibility to environmental exposures. We evaluated whether air pollutant and breast cancer associations varied by familial risk. METHODS Sister Study participants living in the contiguous United States at enrollment (2003-2009; N = 48,453), all of whom had at least one first-degree relative with breast cancer, were followed for breast cancer. Annual NO2 and PM2.5 concentrations were estimated at the enrollment addresses. We predicted 1-year familial breast cancer risk using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA). Using Cox regression, we estimated HRs and 95% confidence intervals (CI) for associations between each pollutant dichotomized at the median and breast cancer with interaction terms to examine modification by BOADICEA score. RESULTS NO2 was associated with a higher breast cancer risk among those with BOADICEA score >90th percentile (HR, 1.28; 95% CI, 1.05-1.56) but not among those with BOADICEA score ≤90th percentile (HR, 0.98; 95% CI, 0.90-1.06; P interaction = 0.01). In contrast to NO2, associations between PM2.5 and breast cancer did not vary between individuals with BOADICEA score >90th percentile and ≤90th percentile (P interaction = 0.26). CONCLUSIONS Our results provide additional evidence that air pollution may be implicated in breast cancer, particularly among women with a higher familial risk. IMPACT Women at higher underlying breast cancer risk may benefit more from interventions to reduce exposure to NO2.
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Affiliation(s)
- Nicole M Niehoff
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York and the Herbert Irving Comprehensive Cancer Center, New York, New York
| | | | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, Washington
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
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